Understanding why IVF fails is essential for couples as they navigate their fertility journeys

Human reproduction is extraordinarily inefficient and fragile. Even with no underlying medical problems or infertility, a couple has only a small chance, around 20%, of conceiving in any given month. This inefficiency applies even to reproduction manipulated with advanced technologies including in vitro fertilization. The hard truth is that IVF fails around half the time and is not guaranteed.

Over the last several decades, IVF has transformed the landscape of reproductive medicine. This technology now offers hope to millions aspiring to conceive. Despite its advancements and successes, many couples still encounter the heartbreaking reality of IVF failure. IVF success rates vary, but according to the Society for Assisted Reproductive Technology (SART) the failure rate (or the percentage of IVF cycles that don’t result in a live birth) is over 50%. 

IVF failure devastates many patients counting on this procedure to build their families. We know that there are many factors that have to be just right for conception to occur, and that goes for IVF, too. Understanding the reasons behind unsuccessful IVF attempts is essential for couples as they go through their fertility journeys.

There are many reasons IVF fails

There are variety of reasons that IVF fails. These reasons can be generally attributed to genetic, anatomical, hormonal, and even auto-immune issues. And sometimes it’s hard to pinpoint the exact scientific reason for why IVF fails. Here are some of the common factors that can contribute to IVF failure:

• Poor quality eggs – As women age, the quantity and quality of their eggs decline. Women over 35 often face lower success rates, primarily due to decreased egg quality, which can result in genetic abnormalities and fertilization issues.
• Poor sperm quality – Low sperm count, poor motility, and abnormal sperm morphology can lead to fertilization issues, ultimately impacting embryo development. Advanced techniques like ICSI (intracytoplasmic sperm injection) may help in such cases.
• Poor embryo quality – Not all fertilized eggs develop into viable embryos. Age of the woman and the overall health of the sperm can influence the resulting embryo quality. Genetic testing of embryos can also reveal problems that may prevent successful implantation.
• Uterine health issues – Polyps, fibroids, uterine structural abnormalities or problems in the uterine lining can hinder the implantation process. Imaging or hysteroscopy is vital before initiating IVF.
• Hormonal imbalances – Polycystic ovary syndrome (PCOS), insulin resistance, or thyroid disorders can disrupt hormonal levels, impacting ovulation and embryo implantation.
• Lifestyle factors – Smoking, excessive alcohol consumption, poor nutrition, and obesity can lead to decreased fertility and lower chances of IVF success. Couples are often advised to adopt a healthier lifestyle in preparation for IVF.
• Underlying medical conditions – Certain medical conditions, including autoimmune disorders, diabetes, and other chronic illnesses, can negatively impact fertility and IVF success. Your health care team can often help you manage these conditions to improve fertility.
• Adhesions and scarring – Prior surgeries in the abdominal area, endometriosis and adenomyosis can lead to scarring or changes in anatomy that affect IVF success.
• Emotional stress and anxiety – IVF takes a toll on your physical and mental health. Seek counseling and support to help with the emotional challenges of fertility treatments.

The real truth about why IVF fails

IVF fails at least half of the time, even when things seem perfect. There are so many factors related to eggs, sperm, the uterus, and a person’s overall health that have to work together perfectly to make a pregnancy happen. Understanding the many reasons that IVF fails can help you plan better for IVF and pregnancy in general.